DESIGNED FOR DISEASE

THE LINK BETWEEN LOCAL FOOD ENVIRONMENTS AND OBESITY AND DIABETES

OVERVIEW. On April 29, 2008 the California Center for Public Health Advocacy (CCPHA), the UCLA Center for Health Policy Research, and PolicyLink released Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes. The report demonstrates that people who live near an abundance of fast-food restaurants and convenience stores compared to grocery stores and produce vendors, have a significantly higher prevalence of obesity and diabetes regardless of individual or community income. Given the enormous personal, social, and economic costs of the obesity and diabetes epidemics, we call on state and local policy makers to take steps to ensure that every California community has a healthy food environment.

Study Documents

Policy BriefA summary of the study, findings, and policy recommendations.

THE STUDY.Designed for Disease builds on CCPHA’s 2007 study, Searching for Healthy Food, which found that California has more than four times as many fast-food restaurants and convenience stores as supermarkets and produce vendors. In the current study, we determined the association between retail food environments and obesity and diabetes rates in California by combining individual-level demographic and health outcome data from the 2005 California Health Interview Survey (CHIS—a representative, biannual survey of Californians) with the locations of retail food outlets from the 2005 InfoUSA Business File. Using geographic information system (GIS) software, we calculated the proportion of fast-food restaurants and convenience stores near each adult CHIS respondent’s home compared to grocery* stores and produce vendors. The Retail Food Environment Index (RFEI) was then arrived at by dividing the total number of fast-food restaurants and convenience stores by the total number of grocery stores (including supermarkets) and produce vendors (including produce stores and farmers’ markets) within a given radius around the person’s home address (0.5 mile in urban areas, 1 mile in smaller cities and suburban areas, and 5 miles in rural areas). For summary information, see the Press Release and Press Kit, an accompanying Policy Brief and a Detailed Study Methodology.

FINDINGS. The study found a strong and direct relationship between the RFEI of the area in which someone lives and their likelihood of being obese or having diabetes. California adults living in high RFEI areas (RFEI of 5.0 or higher) had a 20 percent higher prevalence of obesity and a 23 percent higher prevalence of diabetes than their counterparts living in RFEI areas of 3.0 or lower. A higher RFEI was associated with a higher prevalence of obesity and diabetes for people living in lower-income and higher-income communities alike. The highest rates of obesity and diabetes are among people who live in lower-income and higher RFEI communities. This relationship between RFEI and obesity and diabetes rates was found to hold true regardless of household income, race/ethnicity, age, gender, or physical activity levels of respondents. While not included in the Policy Brief, results for California’s largest counties are available here to help provide a local context for the study.

POLICY RECOMMENDATIONS. Because the food available near where we live affects what we choose to eat, CCPHA, the UCLA Center for Health Policy Research, and PolicyLink call on state and local policy makers to promote a healthy food environment for all Californians by enacting these specific state and local policies.

*In the California Center for Public Health Advocacy 2007 study, Searching for Healthy Food: The Food Landscape in California Cities and Counties, this category of stores was referred to as supermarkets.